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Li W, Xu JW, Chai JL, Guo CC, Li GZ, Gao M, Liang XZ. Complex causal association between genetically predicted 731 immunocyte phenotype and osteonecrosis: a bidirectional two-sample Mendelian randomization analysis. Int J Surg 2024; 110:3285-3293. [PMID: 38498404 PMCID: PMC11175804 DOI: 10.1097/js9.0000000000001327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/03/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Previous studies have explored the role of immune cells on osteonecrosis. This Mendelian randomization (MR) study further assessed 731 immunocyte phenotypes on osteonecrosis, whether a causal relationship exists, and provides some evidence of causality. METHODS The 731 immunocyte phenotypes and osteonecrosis data used in this study were obtained from their respective genome-wide association studies (GWAS). The authors used inverse variable weighting (IVW) as the primary analysis method. In addition, the authors simultaneously employed multiple analytical methods, including MR-Egger, weighted mode, simple mode, and weighted median, to strengthen the final results. Finally, sensitivity analyses were conducted to verify the stability and feasibility of the data. RESULTS The results of the IVW method of MR analysis showed that 8 immunocyte phenotypes were positively associated with osteonecrosis [ P <0.05, odds ratio (OR) > 1]; 18 immunocyte phenotypes were negatively associated with osteonecrosis ( P <0.05, OR<1), none of which were heterogeneous or horizontally pleiotropic ( P > 0.05) or reverse causality. In addition to this, in reverse MR, osteonecrosis was positively associated with 10 additional immunocyte phenotypes ( P <0.05, OR > 1) and negatively associated with 14 immunocyte phenotypes ( P <0.05, OR<1). And none of them had heterogeneity and horizontal pleiotropy ( P > 0.05) or reverse causality. CONCLUSIONS The authors demonstrated a complex causal relationship between multiple immune phenotypes and osteonecrosis through a comprehensive two-way, two-sample MR analysis, highlighting the complex pattern of interactions between the immune system and osteonecrosis.
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Affiliation(s)
- Wei Li
- College of Traditional Chinese Medicine
| | - Jing-Wen Xu
- First College of Clinical Medicine
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | | | - Cong-Cong Guo
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
| | | | - Mei Gao
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Xue-Zhen Liang
- First College of Clinical Medicine
- Orthopaedic Microsurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong
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Ramser A, Greene ES, Wideman R, Dridi S. Potential non-invasive detection of lesions in broiler femur heads: application of the DXA imaging system. Front Physiol 2024; 15:1363992. [PMID: 38827990 PMCID: PMC11140573 DOI: 10.3389/fphys.2024.1363992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/06/2024] [Indexed: 06/05/2024] Open
Abstract
Leg health is a significant economic and welfare concern for the poultry industry. Current methods of detection rely on visual assessment of the legs and gait scores and bone scoring during necropsy for full characterization. Additionally, the current scoring of femurs only examines the external surface of the femoral head. Through the use of the dual-energy X-ray absorptiometry (DXA) imaging system, we show the presence of a necrotic region in the femurs that would otherwise be considered healthy based on the current evaluation procedures. Importantly, these lesions were present in almost 60% (22 of 37) of femurs that scored normal for femoral head necrosis (FHN). Additionally, these femurs showed greater bone mineral content (BMC) relative to weight compared to their counterparts with no lucent lesions (6.95% ± 0.20% vs. 6.26% ± 0.25; p = 0.038). Identification of these lesions presents both a challenge and an opportunity. These subclinical lesions are likely to be missed in routine scoring procedures for FHN and can inadvertently impact the characterization of the disease and genetic selection programs. Furthermore, this imaging system can be used for in vivo, ex vivo, and embryonic (egg) studies and, therefore, constitutes a potential non-invasive method for early detection of bone lesions in chickens and other avian species.
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Affiliation(s)
| | | | | | - Sami Dridi
- University of Arkansas, Center of Excellence for Poultry Science, Fayetteville, AR, United States
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Xu M, Motomura G, Utsunomiya T, Ikemura S, Yamaguchi R, Yamamoto N, Tanaka H, Ayabe Y, Sakamoto K, Wang Y, Nakashima Y. Effects of bone mineral density at the lateral sclerotic boundary on the femoral head collapse onset in osteonecrosis of the femoral head: A preliminary study. Clin Biomech (Bristol, Avon) 2024; 111:106156. [PMID: 38029477 DOI: 10.1016/j.clinbiomech.2023.106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND In the natural course of osteonecrosis of the femoral head, sclerotic changes at the boundary of necrotic lesion gradually occur until femoral head collapse. This study aims to examine the effects of bone mineral density at the lateral boundary of necrotic lesion on a subsequent femoral head collapse. METHODS We developed patient-specific finite element models of 9 hips with subsequent collapse and 10 hips without subsequent collapse. Cubic regions of interest were selected at both subchondral areas of the lateral boundary and the adjacent necrotic lesion. Bone mineral density values of the regions of interest were quantitatively measured, and a ratio of bone mineral density values (lateral boundary/necrotic lesion) was calculated. Stress values at the lateral boundary were also evaluated. FINDINGS The ratio of bone mineral density values was significantly higher in hips with subsequent collapse than that without subsequent collapse (p = 0.0016). The median equivalent stress and shear stress were significantly higher in hips with subsequent collapse than that without subsequent collapse (p = 0.0071, and p = 0.0143, respectively). The ratio of bone mineral density values showed a promising value in predicting the occurrence of subsequent femoral head collapse (AUC = 0.97). INTERPRETATION Our results indicated that bone mineral density value at the lateral boundary of necrotic lesion may be associated with the occurrence of subsequent femoral head collapse in pre-collapse stage osteonecrosis of the femoral head.
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Affiliation(s)
- Mingjian Xu
- Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takeshi Utsunomiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ryosuke Yamaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Noriko Yamamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidenao Tanaka
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yusuke Ayabe
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kousei Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Youhua Wang
- Department of Orthopaedics, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Xue P, Xi H, Chen H, He S, Liu X, Du B. Predictive value of clinical features and CT radiomics in the efficacy of hip preservation surgery with fibula allograft. J Orthop Surg Res 2023; 18:940. [PMID: 38062463 PMCID: PMC10704794 DOI: 10.1186/s13018-023-04431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Despite being an effective treatment for osteonecrosis of the femoral head (ONFH), hip preservation surgery with fibula allograft (HPS&FA) still experiences numerous failures. Developing a prediction model based on clinical and radiomics predictors holds promise for addressing this issue. METHODS This study included 112 ONFH patients who underwent HPS&FA and were randomly divided into training and validation cohorts. Clinical data were collected, and clinically significant predictors were identified using univariate and multivariate analyses to develop a clinical prediction model (CPM). Simultaneously, the least absolute shrinkage and selection operator method was employed to select optimal radiomics features from preoperative hip computed tomography images, forming a radiomics prediction model (RPM). Furthermore, to enhance prediction accuracy, a clinical-radiomics prediction model (CRPM) was constructed by integrating all predictors. The predictive performance of the models was evaluated using receiver operating characteristic curve (ROC), area under the curve (AUC), DeLong test, calibration curve, and decision curve analysis. RESULTS Age, Japanese Investigation Committee classification, postoperative use of glucocorticoids or alcohol, and non-weightbearing time were identified as clinical predictors. The AUC of the ROC curve for the CPM was 0.847 in the training cohort and 0.762 in the validation cohort. After incorporating radiomics features, the CRPM showed improved AUC values of 0.875 in the training cohort and 0.918 in the validation cohort. Decision curves demonstrated that the CRPM yielded greater medical benefit across most risk thresholds. CONCLUSION The CRPM serves as an efficient prediction model for assessing HPS&FA efficacy and holds potential as a personalized perioperative intervention tool to enhance HPS&FA success rates.
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Affiliation(s)
- Peng Xue
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China
| | - Hongzhong Xi
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China
| | - Hao Chen
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China
| | - Shuai He
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China
| | - Xin Liu
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China.
| | - Bin Du
- The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
- Department of Orthopedics, The Affiliated Hospital of Nanjing University of Chinese Medicine, Hanzhong Road 155, Nanjing, 210029, China.
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Pascart T, Falgayrac G, Cortet B, Paccou J, Bleuse M, Coursier R, Putman S, Quinchon JF, Bertheaume N, Delattre J, Marchandise P, Cultot A, Norberciak L, Kerckhofs G, Budzik JF. Subchondral involvement in osteonecrosis of the femoral head: insight on local composition, microstructure and vascularization. Osteoarthritis Cartilage 2022; 30:1103-1115. [PMID: 35568111 DOI: 10.1016/j.joca.2022.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine changes of subchondral bone composition, micro-structure, bone marrow adiposity and micro-vascular perfusion in end-stage osteonecrosis of the femoral head (ONFH) compared to osteoarthritis (OA) using a combined in vivo and ex vivo approach. DESIGN Male patients up to 70 years old referred for total hip replacement surgery for end-stage ONFH were included (n = 14). Fifteen patients with OA were controls. Pre-operative MRI was used to assess bone perfusion (dynamic contrast-enhanced (DCE) sequences) and marrow fat content (chemical shift imaging). Three distinct zones of femoral head subchondral bone - necrotic, sclerotic, distant - were compared between groups. After surgery, plugs were sampled in these zones and Raman spectroscopy was applied to characterize bone mineral and organic components (old and newly-formed), and contrast-enhanced micro-computed tomography (CE-μCT) to determine bone micro-structural parameters and volume of bone marrow adipocytes, using conventional 2D histology as a reference. RESULTS In the necrotic zone of ONFH patients compared to OA patients: 1) the subchondral plate did not exhibit significant changes in composition nor structure; 2) the volume fraction of subchondral trabecular bone was significantly lower; 3) type-B carbonate substitution was less pronounced, 4) collagen maturity was more pronounced; and 5) bone marrow adipocytes were significantly depleted. The sclerotic zone from the ONFH group showed greater trabecular thickness, and higher DCE-MRI AUC and Ktrans. Volume fraction of subchondral bone, trabecular number, and Kep were significantly lower in the distant zone of the ONFH group. CONCLUSIONS This study demonstrated alterations of subchondral bone microstructure, composition, perfusion and/or adipose content in all zones of the femoral head.
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Affiliation(s)
- T Pascart
- Department of Rheumatology, Lille Catholic Hospitals and Lille Catholic University, Lille, France; Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France.
| | - G Falgayrac
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France
| | - B Cortet
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 4490, Department of Rheumatology, 59000 Lille, France
| | - J Paccou
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France; Univ. Lille, CHU Lille, ULR 4490, Department of Rheumatology, 59000 Lille, France
| | - M Bleuse
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France
| | - R Coursier
- Department of Orthopaedic Surgery, Lille Catholic Hospitals and Lille Catholic University, Lille, France
| | - S Putman
- Department of Orthopaedic Surgery, CHU Lille, Lille University, Lille, France
| | - J-F Quinchon
- Department of Anatomopathology, Lille Catholic Hospitals and Lille Catholic University, Lille, France
| | - N Bertheaume
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France
| | - J Delattre
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France
| | - P Marchandise
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France
| | - A Cultot
- Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals and Lille Catholic University, Lille, France
| | - L Norberciak
- Department of Research, Biostatistics, Lille Catholic Hospitals and Lille Catholic University, Lille, France
| | - G Kerckhofs
- Biomechanics Lab - Institute of Mechanics, Materials, and Civil Engineering, Louvain-la-Neuve, UCLouvain, Belgium; IREC - Institute of Experimental and Clinical Research, UCLouvain, Woluwe, Belgium; Department Materials Engineering, Leuven, KU Leuven, Belgium; Prometheus, Division for Skeletal Tissue Engineering, Leuven, KU Leuven, Belgium
| | - J-F Budzik
- Univ. Lille, CHU Lille, Univ. Littoral Côte D'Opale, ULR 4490 - MABLab- Adiposité Médullaire et Os, F-59000 Lille, France; Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals and Lille Catholic University, Lille, France
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6
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Kawano K, Motomura G, Ikemura S, Yamaguchi R, Baba S, Xu M, Nakashima Y. Differences in the microarchitectural features of the lateral collapsed lesion between osteonecrosis and subchondral insufficiency fracture of the femoral head. Bone 2020; 141:115585. [PMID: 32795680 DOI: 10.1016/j.bone.2020.115585] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Like osteonecrosis of the femoral head (ONFH), subchondral insufficiency fracture of the femoral head (SIF) causes femoral head collapse. However, little is known about the differences between the two diseases regarding the morphological features of the collapsed lesion. We tested the hypothesis that the morphological features of the lateral collapsed lesion would differ between ONFH and SIF. METHODS Twenty femoral heads histopathologically diagnosed as ONFH (n = 10) or SIF (n = 10) were used in this study. In the lateral collapsed lesion of each femoral head, cubic regions of interest (ROIs) were selected within the collapsed subchondral area and the nearby non-collapsed subchondral area. Micro-CT-based microarchitectural parameters were compared between the ROIs in each disease. Additionally, correlations between histopathological and microarchitectural features were evaluated. RESULTS In ONFH, bone volume fraction, trabecular thickness, and bone mineral density in the collapsed area were all significantly lower than those in the nearby non-collapsed area where thickened bone trabeculae accompanied by appositional bone formation were invariably seen. On the other hand, in SIF there were no significant differences between the ROIs in any of these microarchitectural parameters. Histopathologically, varying degrees of callus formation overlying the fracture of the subchondral plate were seen around the lateral collapsed lesion. CONCLUSION The morphological features of the lateral collapsed lesion were inconsistent between ONFH and SIF, suggesting different pathomechanisms of femoral head collapse.
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Affiliation(s)
- Koichiro Kawano
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Goro Motomura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Ryosuke Yamaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Shoji Baba
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Mingjian Xu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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